Collaborating with Providers on Gut Health_Final

>> Hi there. Let's chat about a topic that's central to helping clients with any gut health issue. How to work as part of a treatment team? You may have clients who are CGI specialists, functional medicine doctors, herbalists, Ayurvedic practitioners, Chinese medicine practitioners, or any combination of these. You could visit any of these healthcare providers to address the same issue and each would approach it from a somewhat different perspective. In any case, you can lend your support as an Integrative Nutrition Health Coach. Having the basic foundation to navigate the various modalities, and their languages, philosophies, and protocols is so important because it helps you understand your clients and it helps them to feel heard. You can bridge the gap between your clients and their healthcare providers, and you can arm them with knowledge to expand their treatment options and advocate for their health. How great is that? Using Laura as a case study, let's look at how it might be best to help Laura navigate the various practitioners she's seeing. First, let's begin with Laura visiting a GI specialist. As the name implies, these are doctors of modern medicine who specialized in issues of the gastrointestinal tract. The GI doctor has extensive training on the anatomy and physiology of the gut. But her schedule was booked back to back. So she doesn't have much time to spend with Laura. The 10 minutes or so she does spend with her, doesn't allow much time to discuss what's going on. The doctor asks basic questions, listens to her symptoms, and Laura walks away with a diagnosis of GERD. As they discuss her treatments, the GI doctors states that she has two goals, to take away her pain and protect her esophagus. She prescribes a proton pump inhibitor. When Laura asks for how long, the doctor says for as long as she has the symptoms. On the days that her heartburn is really bad, she can also take an antacid. That should do the trick. Laura isn't given a follow-up appointment. She's just told to call if things get worse or if she has any concerns. The nurse sets her up with an online portal where she can communicate with the doctor or her staff. Laura walks away with a diagnosis and a treatment plan. The root cause is not addressed. The goal of the GI doctor is to remove symptoms. This will bring Laura symptom relief but may not be healing her body in the long-term. What's missing from this interaction is time to really get to know Laura, to learn about what's causing her reflux, and why this is happening. She doesn't feel fully heard or understood, and she hasn't received any information on things she can do to naturally ease her reflux or avoid triggers. She's only given a prescription for medication. As an Integrative Nutrition Health Coach, how can you step into the picture to fill these gaps? What can you do from within your scope of practice to complement the treatment that Laura is receiving from her GI specialist? Grab a pen and a piece of paper and pause the video now to jot down your ideas. How'd that go? See, there are many ways that you can work that complement rather than compete with doctors. You could help Laura identifying the root causes for heartburn by helping her identify and crowd out triggers. You could help her gain more awareness into what and how she's eating, and you can help her manage her stress. You can help Laura improve her health overall in a variety of ways that wouldn't come into conflict with the doctor's treatment plan. And if you did have a recommendation that would need her approval, the online portal would be a great place to connect. In fact, you can encourage Laura to utilize this tool to help her communicate with her doctor, coaching her on what important questions she may want to ask such as "What are the risks of the proton pump inhibitor? Are there any alternatives that might be safer? Is there a way to evaluate if my condition is due to low stomach acid?" A doctor's job is to help treat a condition and its symptoms so that a larger problem doesn't occur. This is a valid and important approach. Your job is to support their treatment plan and look for ways that you can empower clients to improve their diet and lifestyle to achieve better health. And when clients feel like they're not finding the solution to their health concerns, you can help them connect with additional resources. For example, let's say that Laura is wary of indefinitely using a proton pump inhibitor and feels like her GI specialist isn't helping her get to the root cause of what's going on. You may recommend that Laura visit a functional medicine doctor. A functional medicine doctor is an MD who has gone through functional medicine training. Functional medicine is systems-based, meaning that this approach views the body as a complex hub of integrated systems and parts. Functional medicine doctors offer alternative holistic approaches that aim to get to the root of a problem. The functional medicine doctor who Laura visits wants her to temporarily eliminate foods that commonly trigger heartburn and reflux. She explains that heartburn can be caused by intolerances and helps Laura to go on a diet that eliminates gluten, dairy, and processed foods. If this doesn't help, she'll have Laura take an IGD test to identify her food intolerances. Together they'll go through a trial and error process to determine the cause of her GERD. A functional medicine doctor might also suggest digestive supplements and an HCL supplement. How can you support Laura now that she's seeing a functional medicine doctor? You still have an important role to play. Can you think of what you would do? Pause now to jot down your ideas. What did you come up with? Here are three ways we came up with for how you could support Laura in this situation. You could help her come up with satisfying meal ideas given the foods available to her on her elimination diet. You could educate Laura on how to pick out a quality supplement. And if they're struggling to figure out the root cause, you can make suggestions for Laura to discuss this with her practitioner. For example, SIBO is a commonly overlooked cause of heartburn. You could suggest that Laura ask her doctor if this might be something worth exploring. You may also consider working directly in collaboration with a functional medicine doctor. Many are willing to work directly with Health Coaches. See if you can set up an e-mail correspondence, if both parties approve. Here's another direction this could take. Let's say Laura chooses to see an herbalist. An herbalist uses plants and natural substances to promote health and healing. An herbalist will work with Laura to address her digestion and soothe her reflux. Something important to keep in mind is that there is no national certifying or licensing body for herbalists in United States. There are many schools that provide certifications to call oneself an herbalists but there's no one official certification. Herbalists have a scope of practice to follow just like Health Coaches. So you'll want to make sure that clients like Laura are still connecting with their primary doctor to prove any herbs or supplements an herbalist recommends. An herbalist may work with Western, Ayurvedic, or Chinese herbs. It's helpful to inquire if they have a specialty and where they received their training. Western herbalists often trained via mentorship. Chinese herbalists often study herbs while in acupuncture school. Ayurvedic herbalists learn their trade by learning Ayurvedic medicine. Helping a client clarify their goals and interests for pursuing an herbalist can help them find a practitioner who works best for them. Herbalists aren't necessarily trained in nutrition or gut health. They'll look to herbs to promote health in the way that a Health Coach looks to foods. And here too, this can involve a bit of trial and error. Laura's herbalist suggests that she take digestive bitters. After a week, she decides that the bitters actually make her acid reflux worse. This might indicate that Laura actually does have either high stomach acid or a weak lower esophageal sphincter muscle. So instead, the herbalist now recommends cooling herbs like licorice, meadowsweet, and mallow. How can you help? Do you have any ideas? If so, feel free to pause the video and write them down. An important way to help overall is to help your client get clear on what exactly the herbalist is trying to achieve and the steps you can take to support what they're doing. For example, is he or she recommending lubricating and mucilaginous herbs for the purpose of soothing the GI tract? Once you know what the objective is, you can ask how you can complement this objective through diet. So for example, maybe you could recommend soothing foods like oatmeal or pureed vegetable soups. You can also inquire about if and when any foods can be used to balance an herbal remedy. For example, maybe those digestive bitters are irritating to Laura because she eats a lot of acidic foods in her diet. You and the herbalist can work together to troubleshoot. Let's say Laura decides to see a practitioner who's trained in Ayurveda. He or she will look at body type and history to determine Laura's primary Doshas and where an imbalance is occurring. Laura is most likely a Vata since she's thin and wiry. However, her imbalance is in Pitta. Heartburn is a Pitta imbalance treated as high stomach acid. An Ayurvedic practitioner will look to balance the Doshas. Balancing the Pitta Dosha will consist of dietary, lifestyle, and emotional components. Part of your job as an Integrative Nutrition Health Coach will be to support your client through the process and make sense of how to apply these tools. For instance, Pittas need to cool off and surrender. Where can Laura do this in her life? Pause the video now and take a moment or two to brainstorm. All right, applying basic principles of Ayurveda, Laura may be advised to try cooling off by avoiding spices and spicy foods. She may also be advised to avoid Vata aggravating foods. You'll want to make sure she's being supported with proper nutrition and that she understands what the recommendations are that are being made and why. You could help Laura by asking her questions about her visits with the Ayurvedic practitioner, the treatment she's getting, how well she is implementing it, and how it's making her feel. Another way to be useful is to play a triage role, making sure that the Ayurvedic practitioner's treatment is in line with that of her doctor and pointing out any discrepancies where they might be at odds with one another. Let's visit one more practitioner. Let's imagine that Laura decides to visit an acupuncturist who's also a Chinese herbalist. As part of their training, all licensed acupuncturists are required to spend at least one year studying Chinese herbs. This practitioner will look at Laura's tongue in addition to taking her pulse. Many diagnoses in traditional Chinese medicine rely on readings of the pulse and tongue, which in addition to revealing symptoms are believed to help identify the organs causing the imbalance. Even though heartburn is an issue with digestion which is ruled by the spleen and stomach in traditional Chinese medicine, a Chinese practitioner will look to see where deficiencies in other various organs maybe contributing to the problem. This diagnosis maybe hard to relate to and can be quite complicated especially to people who are new to Chinese medicine. Your job isn't to know the answers, but you can help Laura to get clear on what it is she is uncertain about and formulate helpful questions that she or both of you can bring to the practitioner. You can also ask how you can complement the work that the Chinese medicine practitioner's doing with your client in terms of diet and lifestyle. It's helpful to pass information back and forth both ways. The more you begin to understand this modality, the more you can support clients like Laura as they navigate alternative types of medicine. And if you can develop a relationship with a particular practitioner, over time you can help them better understand the power of health coaching and how it can enhance the work that they do. One thing to keep in mind when discussing traditional Chinese medicine is that you'll want to stay within the context of Chinese medicine in terms of language and concepts as it may be hard to translate back and forth between in modern approach. If you don't understand the information you're being given, don't be afraid to ask questions. This will only manage your clients the importance of gathering information in the journey to better health. Keeping all this in mind, let's see how this plays out for Laura. Her Chinese medicine practitioner diagnosis her with a spleen deficiency and says that Laura isn't properly transporting and transforming nutrients. She thinks this might be related to Stagnant Liver "Qi" which is compromising the spleen. For this reason, she recommends supporting the liver. What do you do with this information? You could check in with Laura to see if she understands what's going on. See how she feels about that type of diagnosis and this type of treatment. And ask her doctor what foods could support the liver and help Laura incorporate these into her diet. The practitioner may or may not understand the concept of primary food. But since she suspects the issue is connected to the liver, she may assume there's an underlying anger issue. This is something you could explore with Laura. Does she have pent-up anger in her life? How could she release any anger she's holding onto? Whether or not releasing anger in Laura's life improves her heartburn, overall, it will make her feel better and work in favor of her health. No harm in that. This practitioner may also offer to treat Laura through acupuncture. Acupuncture provides relief but the symptoms often come back. It's still important to get to the root cause. You could encourage Laura to ask her practitioner to teach herself acupressure points that she can do at home. You could also support her to eat slowly and chew her food, help her to create a calm environment around meal times, establish more of a schedule around meals, and create a safe place for her to talk about her emotions. In addition to acupuncture, a Chinese practitioner will often provide Chinese herbal formulas full of hard to pronounce herbs. Empower Laura to be an educated consumer, and encourage her to ask her practitioner to explain what the herbs are and what they're meant to do. These herbs typically aren't regulated. So you want to encourage her to run them by her primary doctor before trying anything new. You can help your clients merge eastern and western heeling into a treatment that works for them and their individual needs. Now let's recap. As an Integrative Nutrition Health Coach, your role can complement that of other practitioners by helping clients connect the dots with what's going on at the root, providing support as they implement various treatment plans, and providing clients with what they're not getting elsewhere. It's important to help clients like Laura stay aware of her feelings and changes in their body and to check in regularly to see what's working, what isn't, and what might be missing. As you saw in this lecture, there are many types of practitioners a client may work with. What it comes down to is helping clients figure out what will best suit his or her bio-individual needs. You can support your clients with this while also figuring out how to add your own value to the healing process in conjunction with others. Being territorial of your clients and viewing other practitioners as competition will go against your mission to support and empower your clients to feel their best. We hope you now have a better idea of the ways that you can support clients who work with other practitioners. A good analogy for this comes from sports. In baseball, a player has a coach for batting, a coach for pitching, and a coach for base running. They all work together to help the player become the best all around player they can be. What role do you play as an Integrative Nutrition Health Coach to your clients? Have you worked with various practitioners? Let's carry the conversation over to the Facebook group. Until next time.